Medical College, Aga Khan University, Stadium Road, Karachi 74800, Pakistan.
Head Face Med. 2010 Nov 11;6:26. doi: 10.1186/1746-160X-6-26.
Ectopic eruption of teeth in non-dental sites is a rare phenomenon and can present in a variety of ways such as chronic or recurrent sinusitis, sepsis, nasolacrimal duct obstruction, headaches, ostiomeatal complex disease and facial numbness. However, presentation of such patients with recurrent haemoptysis has not been described in the literature so far. We have described a case of an ectopic, supernumerary molar tooth in the maxillary antrum in a patient who initially presented with haemoptysis.
A 45-year-old male presented with a 2-month history of episodic haemoptysis. A pedunculated growth from the inferior nasal turbinate was seen with fibre-optic visualization. Although the patient was empirically started on antibiotic and anti-allergic therapy, there was no improvement after a few weeks and the patient had recurrent episodes of haemoptysis. Fibre-optic visualization was repeated showing bilateral osteomeatal erythema. Computed tomography scan of the paranasal sinuses demonstrated complete opacification of the left maxillary antrum along with a focal area of density comparable to bone. An ectopic, supernumerary molar tooth was found in the left maxillary antrum on endoscopic examination and subsequently removed. In addition, copious purulent discharge was seen. Post-operatively, the patient was treated with a 10-day course of oral amoxicillin-clavulanate. On follow-up, he reported resolution of symptoms.
Recurrent haemoptysis has not been described as a presentation for a supernumerary, ectopic tooth in literature before. We recommend that in patients with sinusitis-type of opacification of maxillary antrum and whose condition is refractory to conventional medical treatment, consideration should be given to the investigation of possible underlying anomalies as the cause of such symptoms. Presence of foreign bodies and ectopic teeth in paranasal sinuses can be reliably excluded with the use of appropriate radiological imaging and endoscopic examination.
牙齿异位萌出在非牙科部位是一种罕见现象，其表现形式多种多样，如慢性或复发性鼻窦炎、败血症、鼻泪管阻塞、头痛、中鼻甲复合体疾病和面部麻木等。然而，目前文献中尚未描述过此类患者出现复发性咯血的表现。我们描述了一例上颌窦内异位多生磨牙的病例，患者最初表现为咯血。
一名 45 岁男性因 2 个月间歇性咯血就诊。纤维光学检查可见下鼻甲有一带蒂生长物。尽管患者经验性地接受了抗生素和抗过敏治疗，但数周后仍未见改善，且患者反复发作咯血。再次进行纤维光学检查显示双侧中鼻甲红斑。鼻窦计算机断层扫描显示左侧上颌窦完全闭塞，伴有与骨密度相当的局灶性密度区。在内镜检查中发现左侧上颌窦内有一颗异位、额外的磨牙，并随后将其切除。此外，还可见大量脓性分泌物。术后，患者接受了 10 天疗程的口服阿莫西林克拉维酸钾治疗。随访时，患者报告症状已缓解。
复发性咯血在文献中尚未被描述为异位多生牙的表现。我们建议，对于上颌窦呈鼻窦炎样混浊且经常规药物治疗无效的患者，应考虑将潜在异常作为此类症状的原因进行调查。异物和异位牙可通过适当的影像学和内镜检查可靠地排除。
